You have a few options when you are unable to find a network pharmacy in your area.
First, since most Medicare Part D
prescription drug plans have between 50,000 to 65,000+ participating pharmacies
across the United States where you can use your plan, you can telephone your
Medicare Part D plan’s Member Services department (the toll-free telephone number is printed on your Member ID card) and ask a Member Services representative to help
you find the nearest network pharmacy.
Your Medicare plan probably also has an online pharmacy search tool that you can use as you travel to see both standard and preferred network pharmacies. If you do not know where to begin, you can use our pharmacy and provider
search tool articles for instructions and links to the search tools for a few of the most popular Medicare plans.
If you find yourself in an area of the country where there are no network pharmacies, you can always purchase your medications at full-price from a non-network pharmacy and then later submit the prescription receipts for reimbursement to your Medicare Part D plan.
As reference, you can read about using a non-network pharmacy in your Medicare plan's Evidence of Coverage (EOC) document (that you received when you joined your plan or in October if you stayed with the same Medicare plan from last year).
You probably will find text in your EOC Chapter 3. "Using the plan's coverage for your Part D prescription drugs", Section 2.5 "When can you use a pharmacy that is not in the plan's network?" that states something such as:
Other times you can may have your prescription covered if you go to an out-of-network pharmacy.You probably will find text in your EOC Chapter 3. "Using the plan's coverage for your Part D prescription drugs", Section 2.5 "When can you use a pharmacy that is not in the plan's network?" that states something such as:
"If a network pharmacy is not available, [the Medicare plan] will cover prescriptions that are filled at an out-of-network pharmacy if you follow all other coverage rules identified within this [EOC] document. In this situation, you will have to pay the full cost (rather than paying just your copayment or coinsurance) when you fill your prescription.
If the prescription is covered, it will be covered at an out-of-network rate. You may be responsible for paying the difference between what [the Medicare plan] would pay for a prescription filled at an in-network pharmacy and what the out-of-network pharmacy charged for your prescription. You can ask us to reimburse you for our share of the cost by submitting a paper claim form. ([EOC] Chapter 5, Section 2.1 explains how to ask the plan to pay you back.)
Please recognize, however, that multiple non-emergency occurrences of out-of-network pharmacy claims will result in claim denials. In addition, we cannot pay for any stolen medications or prescriptions that are filled by pharmacies outside the United States and territories, even for a medical emergency, for example on a cruise ship...."
"[The Medicare plan] will [also] cover your prescription at an out-of-network pharmacy if at least one of the following applies:Please keep in mind - as noted in the example Evidence of Coverage text above - your Medicare Part D plan may not reimburse you for the full out-of-network purchase price, if the drug cost at an out-of-network pharmacy exceeds the plan’s negotiated retail drug price.
• You can't get a covered drug that you need immediately because there are no open in-network pharmacies within a reasonable driving distance.
• Your prescription is for a specialty drug in-network pharmacies don't usually keep in stock.
• You were eligible for Medicaid at the time you got the prescription, even if you weren't enrolled yet. This is called retroactive enrollment.
• You're evacuated from your home because of a state, federal, or public health emergency and don't have access to an in-network pharmacy."
Important Tip: Please do not just send your receipts to your Medicare Part D plan for reimbursement. First, contact your Medicare Part D plan Member Services department for more details about the reimbursement procedures (or review your EOC document). As noted, the toll-free number for Member Service is on your Member ID card or your plan's printed information. Next, follow the reimbursement procedure outlined by the Member Services representative (or your EOC) - and retain copies of all receipts and forms for your reference.
As another option outside your Medicare Part D coverage
You can check prices using a drug discount card at pharmacies in your current location. As noted by Medicare, "[you] will need to send their receipt to their Medicare drug plan. This ensures that [your] plan will count the amount [you] paid towards [your] out-of-pocket costs [(TrOOP)]." [link added]
» Check Local Pharmacy Prices Using a Drug Discount Card.